High Deductible Health Insurance Plans

The impact of the recession on our local economy has been severe, especially considering the number of folks who have been affected by the loss of jobs in construction,and the number of state employees affected by furlough programs.

I think one of the tough choices folks are having to make is in choosing health plans that are lower in monthly premiums, but leave a lot of out-of-pocket costs to the patient in terms of annual deductibles, coverage only of generic medicines and/or coverage only of preventive care (or everything but - such as only ER and hospitalizations).

These high-deductible plans (so called "crash and burn" or catastrophic coverage plans) are attractive insofar as the monthly cost in premiums is lower or at least manageable.

The problem is that these plans were never really geared for families or for patients over about 30- 35 years old. These plans have been around for quite a while, but the target market was always young healthy employees just out of school and off their parents' insurance who rarely got sick and would typically just need annual Pap smears and coverage of emergencies or catastrophes such as car accidents and traumatic injuries, or unexpected severe illnesses needing hospitalization.

These plans were never really intended for folks living in what the insurance industry calls "elephant country"- the age at which you are actually increasingly likely to need the insurance for sudden problems like heart attacks, strokes or cancers, or for chronic problems like high blood pressure or diabetes. For families or for patients over 30- 35, you can actually end up either spending more money out of pocket in a year than you would have by having a more comprehensive insurance plan, or you can find yourself doing without necessary medical care. Or both.

Please look closely at these kinds of health insurance plans; it's really important to look beyond the monthly premium and also look at the possible costs to you of medicines, physicals, appointments or tests over the year and whether you have the reserves to handle the cost of these or not. The situation you'd like to avoid is where you use the catastrophic coverage for a medical catastrophe that could have been avoided or prevented.

Otherwise, please let us know if you have such a plan. We are happy to work with you in any way we can in order to provide the best medical care, but we have no way to know whether anything we prescribe for you or recommend to you represents a problem for you unless you let us know!